1. Specification for Buying
- Choice of material / Does it fit the requirements?
- Certificate of quality from the manufacturer.
- Choice of surface finish.
2. Storage of Instruments
- Avoid any corrosive fumes / chemicals in storage area.
- Avoid area of high moisture to store instruments
- Brand new instruments should be cleaned / protective caps removed.
- Appropriate racks / containers should be used to store instruments.
- Clean the instruments after every use.
- Avoid prolonged exposure to saline.
- Sterilise used and unused instruments.
4. Preparation for Disinfection & Cleaning
- Check the correctness of the delivery.
- Returning of the Instruments from OT:- Dry instruments should be returned in dry condition.
- Returning instruments in wet condition:- Instruments should be immersed in a non-corrosive combined with disinfecting cum cleaning solutions.
- All hinges / latches of instruments should be released. Assembled instruments should be dismantled.
5. Reusing Instruments
- Dismantle and immediately immerse used and soiled instruments, completely in a pre-disinfection bath.
- Use containers which are hermetically sealed during the process of thermal disinfection and cleaning. It is done at 93'C for approx. 10 min. For heat-sensitive material, chemo thermal disinfection is done at 60'C for approx. 10 min.
- Open the containers at 60'C or lower
6. Pre - Disinfection
- Use cold water only. Water over 45'C leads to coagulation of proteins and causes cleaning problems.
- Epidemic Hygiene Aspect - disinfection first followed by cleaning. General Hygiene Aspect - first cleaning followed by disinfection.
- Follow exposure times / dilution parameters / concentration levels as recommended by the manufacturer for optimal cleaning / disinfection, pH value 4.5 to 9.5 is recommended for cleaning and disinfection solutions.
- Ultrasonic cleaners may be used in case of stubborn stains / encrustations.
- Periodically test water for its chloride / silicate and mineral content.
- Use of enzyme based detergents is recommended and instructions for dilutions as recommended by the supplier should be followed. If powered products are being used - particles should be dissolved.
- Final rinsing should be done in demineralised water.
- Instruments should be dried immediately after rinsing / washing.
- Use of air pistol is recommended where ever possible.
- Use lint free paper / cloth to wipe.
9. Care of Instruments
- Ensure all instruments are clean.
- Check functionality of individual instruments.
- Separate instruments which are not functioning correctly, showing signs of corrosion and wear & tear.
10. Maintenance for Instruments
- Periodically lubricate hinged/latched instruments and instruments with joints using lubricating oil.
- Inspect edges of cutting instruments and sharpen if required. Inspect instruments with carbide tips for wear and tear. Replace tips if required.
- Always arrange instruments systematically in terms of size, old or new, large bulky instruments and micro delicate instruments.
11. Conditions for Sterilisation
- Do not overload instruments trays with more than 10 Kgs.
- Do not mix old instruments with new instruments.
- Micro and delicate instruments should be placed in secure containers.
- If all necessary steps prior to sterilisation have been followed - proceed.
- Use demineralised water if possible / Quality of water / steam is very important.
- Excessive silicates in water cause blackening of instruments.
- Excessive chlorides can set in corrosion in instruments (level of chlorides should be less than 120mg / I equiv to 200mg / I of nacl).
- Optimal loading of trays prevents formation of condensates.